经导管闭合房间隔缺损的疗效观察

Transcatheter occlusion of secundum atrial septal defect with the Amplatzer septal occluder

目的 评价经导管置入Amplatzer封堵器治疗继发孔型心房间隔缺损 (ASD)的疗效。方法 11例患者中男 3例 ,女 8例 ,年龄 4～ 46岁 (平均 2 5岁 )。术前经多普勒超声心动图检查房间隔缺损直径为 12～ 2 8mm ,平均 (18.5± 6 .1)mm。在透视及经超声心动图引导下经导管置入Amplatzer封堵器闭合ASD。结果 11例ASD直径的球囊测量值为 (2 5 .2± 8.3)mm(15～ 36mm) ,选择的封堵器直径为 (2 5 .4± 7.7)mm(15～ 36mm)。 11例封堵器置入均获得成功 ,术中无并发症。 2例术后即刻超声检查显示微量残余分流。术后 1周复查均无分流。结论 经导管置入Amplatzer封堵器治疗ASD是一种有效的非手术方法。

Objective To evaluate the efficiency of transcatheter occlusion of secundum atrial septal defect (ASD) using Amplatzer occluder. Methods There were 11 patients (3 male, and 8 female, mean age 25.3±14.00 years), ranging from 4 to 46 years. Echocardiography confirmed the ASD with a diameter of 18.51±6.10 mm (ranging from 6 to 28mm). All patients with ASD were treated with using the Amplatzer occluder under guidance of fluorscopy and Echocardiography through percutaneous approach. Results The mean balloon stretched diameter of the ASDs in 11 patients was 25.20±8.30mm(15～36mm). The mean diameter of the occluder selected was 25.40±7.71mm(15～36mm). The successful rate of placement of the Amplatzer occluder was 100%. No complication was found during the procedures and the followo up. Trivial residual shunt was found in 2 patients immediately after the procedures, and there was no residual shunt 1 week after the procedures and during follow up. Conclusions Transcatheter closure of secundum ASD using the amplatzer septal occluder is an efficient nonsurgical method.